Palliative oral care in terminal cancer patients:Integrated review

BACKGROUND Palliative care(PC)aims to improve quality of life in patients and its families against life threatening diseases,through suffering’s prevention and relief.It is the duty of the dental surgeon to possess the knowledge needed to treat a patient with little life span,in order to establish an adequate treatment plan for each situation.AIM To synthesize the published evidence on oral conditions,impact,management and challenges in managing oral conditions among palliative patients.METHODS Articles were selected from PubMed and Scopus electronic platforms,using a research strategy with diverse descriptors related to“palliative care”,“cancer”and“oral health”.The article’s selection was done in two phases.The first one was performed by the main researcher through the reading of the abstracts.In the second phase two researchers selected eligible articles after reading in full those previous selected.Data was tabulated and analyzed,obtaining information about what is found in literature related to this subject and what is necessary to be approached in future researches about PC.RESULTS As results,the total of 15 articles were eligible,being one a qualitative analysis,13(92.8%)clinical trials and one observational study.Of the 15 articles,8(53.4%)involved questionnaires,while the rest involved:one systematic review about oral care in a hospital environment,2 oral exams and oral sample collection,one investigation of terminal patient’s(TP)oral assessment records,2 collection of oral samples and their respective analysis and one treatment of the observed oral complications.CONCLUSION It can be concluded that the oral manifestations in oncologic patients in terminal stage are,oral candidiasis,dry mouth,dysphagia,dysgeusia,oral mucositis and orofacial pain.Determining a protocol for the care of these and other complications of cancer–or cancer therapy–based on scientific evidence with the latest cutting-edge research results is of fundamental importance for the multidisciplinary team that works in the care of patients in PC.To prevent complications and its needed to initial the dentist as early as possible as a multidisciplinary member.It has been suggested palliative care protocol based on the up to date literature available for some frequent oral complications in TP with cancer.Other complications in terminal patients and their treatments still need to have further studying.

Relation between Family Functioning and Quality of Life among Family Caregivers of Patients with Terminal Cancer Hospitalized in General Wards

Caring for a patient with terminal cancer poses difficulties for family caregivers. Although families of patients with cancer have been classified by type, little is known about the relation between family functioning and quality of life (QOL) in family caregivers. This study aimed to develop a typology of family functioning in family caregivers of patients with terminal cancer and then examine the relation between the family functioning and QOL of family caregivers. From December 2013 to August 2014, fifty-one family caregivers of patients with terminal cancer were recruited at three hospitals in Tokyo, Japan. Perceptions of family functioning were assessed with the Family Relationship Index, and its three subscores were classified into three groups by cluster analysis. Caregivers’ QOL was measured with the Caregiver Quality of Life Index-Cancer. The average total FRI score among 51 caregivers was 8.5 (SD = 2.8). Family functioning was categorized into three clusters: supportive (n = 12), communicative (n = 30), or conflictive (n = 8). Their QOL was categorized into two groups: the communicative group, with relatively high confliction, showed high QOL comparable to the supportive group. Family functioning in the families of patients with terminal cancer hospitalized in general wards was not good. For improving the QOL of family caregivers, it may be important for the family members to express their feelings and distress if they have conflicts.

What Contributes to Satisfaction with Care for Family Caregivers of Terminal Cancer Patients Admitted to General Wards? A Qualitative Study

Satisfaction with care is an important indicator for family caregivers of patients with terminal cancer and is linked to the quality of life. Despite this, few studies have examined the aspects of satisfaction with care of family caregivers of inpatients with cancer in general wards. This qualitative study aimed to elucidate the elements of satisfaction with the care that inpatients with terminal cancer in general wards and their family caregivers receive from medical staff, as perceived by the family caregivers. Semi-structured interviews were conducted with 10 family caregivers of inpatients with terminal cancer. Participants were asked about the care received until then from medical staff, the features of satisfactory care, and the aspects of care they felt were unsatisfactory or could become satisfactory with improvement. The data were analyzed with the content analysis method and the six categories were extracted. For family caregivers of inpatients with terminal cancer in general wards, along with the care identified as important in palliative care, the methods of alleviating symptoms and explaining the patient’s condition were also important. The results highlight the importance of determining a patient-oriented approach and explanations together with each patient and family caregiver, based on an understanding of the long treatment process.